Urinary incontinence after greenlight laser photoselective vaporization of the prostate, a case report

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Date: Mar. 2017
Publisher: Asociatia pentru Cresterea Vizibilitatii Cercetarii Stiintifice (ACVCS)
Document Type: Article
Length: 2,194 words
Lexile Measure: 1490L

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Abstract :

Introduction In recent years, the surgical treatment of benign prostatic hyperplasia has focused on minimally-invasive endoscopic procedures, promising the same functional outcomes but lower perioperative complications compared to traditional techniques such as open prostatectomy and transurethral resection of the prostate (TURP). Case report We present the case of a 65-year old man who presented to our department describing urinary incontinence episodes after he had undergone a greenlight laser (KTP) photoselective vaporization of the prostate. Seven months after the laser vaporization the patient underwent a TURP. After this procedure the symptoms did not subside, so after an urodynamic evaluation, he was prescribed antimuscarinics, which had no effect. The patient started treatment with solifenacin succinate 10 mg OD for 6 months and after that the urodynamic tests were repeated and the results were in normal parameters with the exception of a higher level of bladder pressure during the filling phase, about 10 cm [H.sub.2]O. We considered that decreasing this pressure might prevent the urinary leakage, so we decided to perform a set of 30 intradetrusorian injections with botulinum toxin 500 Speywood units. After this treatment the symptoms subsided and after 2 months an urodynamic investigation revealed a storage pressure of 3-4 cm [H.sub.2]O, with no leakage or detrusor instability. Two years after this treatment the patient has no urinary incontinence and no current need for further treatment. Conclusion An incomplete preoperative evaluation in addition to the use of a surgical technique that has not established itself over time had led to the development of a bothersome symptomatology, lasting about 2 years and having a severe emotional impact on the patient. Keywords Urinary incontinence, photoselective vaporization of the prostate, green laser

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Gale Document Number: GALE|A558822624